Participate in a Research Study for Hair Loss

Those who qualify may receive:

  • Payment up to $1,425
  • Study-related care at no cost from local doctors
  • Study medication at no cost

Plus, no cost to you. No health insurance or referral needed.

Prequalification Form

Name*
Date of Birth*
State/Province
ZIP Code
For the phone number you provided above please specify:*
Please confirm we can contact you by phone (text or call):*
Are you a male, 18-45 years of age?*
Would you say you are actively experiencing hair loss?*
Has it been at least 3 years since you started experiencing hair loss?*
If you qualify and choose to join this study, would you be able to travel to a local study location approximately 10 times in about 6 months?*
Note: You will not prequalify if you select "Neither."
If you qualify, are you willing to maintain the same hairstyle and have your hair clipped during clinic visits?*
Have you used any medications or received any treatments/procedures for your hair loss?*
How did you hear about this clinical research study?*

User Agreement

By selecting “I Agree” below, I understand that the personal information I have provided may be collected, shared, used and/or transferred by the study team for the sole purpose of enabling me to be contacted to learn more about the study, see if I am suitable to take part in this study, and if appropriate, to assist me in enrolling in this study.  I understand there is no guarantee that I will be contacted by a member of the study team as a result of submitting my personal information. I also understand that I may be contacted in the future about other studies for which I may qualify. I acknowledge that I may withdraw interest in participating in the study at any time by speaking with a member of the study team or representative.  

By selecting “I Agree” below, I verify that: 

  • The name and contact information I have provided belong to me, are correct, and that I am consenting to being contacted (by Text, Email, or Phone) about this or future studies 
  • I am 18 years or older 
  • I have read and understood the Legal Notice and Privacy Statement
Do you agree to the above statement?*
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